How patterns of injecting drug use evolve in a cohort of people who inject drugs

This research found an overall movement away from street based drug purchasing and drug use, towards more activity in private settings, which has important implications for the harms experienced by people who inject drugs. Foreword This paper investigates the frequency of intravenous drug use in a cohort of people who inject drugs, and the decline in use over time. It provides an important indication of the effectiveness of current interventions at reducing the consumption of illicit drugs. Comparisons are made between the injection frequency of participants on or off Opioids Substitution Therapy (OST), and according to the settings in which drugs are most frequently purchased and used (eg street, house). This research found an overall movement away from street based drug purchasing and drug use, towards more activity in private settings. This has important implications for the harms experienced by people who inject drugs. Intravenous drug use was persistent, with only slow declines observed in the frequency of the cohort’s overall use. Lower injection frequency was associated with use in private rather than public locations as well as the uptake of OST. Additional work is needed to understand how this change in setting is affected by and also affects current interventions, and whether it can be used to help further reduce injecting drug use

Bulletin No. 12: System dynamics modelling using a stocks and flows approach

One of the key components of the first phase of the DPMP project has been to develop a quantitative dynamic model of drug use in Australia. Using a stocks and flows approach, derived from similar work undertaken in the US on cocaine prevalence by Caulkins and collaborators, the key aim of this component of the DPMP has been to examine whether methods can be applied to the Australian context using available data. If a plausible model could be developed, then the subsequent aims were to use the model to describe: 1.The prevalence of drug use in Australia over time; and 2. the effects of changes in model parameters upon the prevalence of injecting drug use and the associated social costs

Bulletin No. 6: Illicit drugs in Australia: What do we know about the role of price?

There has been an increasing awareness of the importance of using price information to understand illicit drug markets. Internationally, researchers have found relationships between illicit drug prices and other market characteristics such as the numbers of drug users, the proportion of arrestees testing positive to drugs and the number of drug-related emergency department incidents. This work aimed to assess whether the Australian heroin market shares the same basic characteristics (e.g. real prices falling over time, significant price variability) as other illicit drug markets where more price analysis has been done; and begin to explore the relationship between price and harm. It is hard to measure how much heroin is being consumed with any precision, making it extremely difficult to understand the relationship between drug use and the harmful consequences that result from use. On the other hand other market characteristics, such as price, can be better measured. If there are relationships between price (as an indirect measure of consumption) and harms, we can use price (and potentially other market data) to assess harms and policy responses

Placing the poor while keeping the rich in their place

A central objective of modern US housing policy is deconcentrating poverty through "housing mobility programs" that move poor families into middle class neighborhoods. Pursuing these policies too aggressively risks inducing middle class flight, but being too cautious squanders the opportunity to help more poor families. This paper presents a stylized dynamicoptimization model that captures this tension. With base-caseparameter values, cost considerations limit mobility programs before flight becomes excessive. However, for modest departures reflecting stronger flight tendencies and/or weaker destination neighborhoods, other outcomes emerge. In particular, we find state-dependence and multiple equilibria, including both de-populated and oversized outcomes. For certain sets of parameters there exists a Skiba point that separates initial conditions for which the optimal strategy leads to substantial flight and depopulation from those for which the optimal strategy retains or even expands the middle class population. These results suggest the value of estimating middle-class neighborhoods' "carrying capacity" for absorbing mobility program placements and further modeling of dynamic response.housing policy, multiple equilibria, negative externality, optimal control, segregation, separation, Skiba point

Material Support: Counternarcotics vs. Counterinsurgency in Afghanistan

Microeconomic analysis of counternarcotics strategies in Afghanistan suggests that current policies lend material support to the enemy. Vigorous enforcement can increase the flow of funds to insurgents and other parties that profit from trafficking. Rural-development programs, promoted as elements of a counternarcotics strategy, are open to some of the same objections. The benefits of drug-fighting in Afghanistan for consumer countries in Europe and North America are likely to be modest. Anti-corruption efforts in Afghanistan and demand-reduction programs both in Afghanistan and in consumer countries, insofar as they are feasible, could serve both counternarcotics and counterinsurgency objectives

Why the DEA STRIDE data are still useful for understanding drug markets

In 2001, use of the STRIDE data base for the purpose of analyzing drug prices and the impact of public policies on drug markets came under serious attack by the National Research Council (Manski, et al., 2001; Horowitz, 2001). While some of the criticisms raised by the committee were valid, many of the concerns can be easily addressed through more careful use of the data. In this paper, we first disprove Horowitz's main argument that prices are different for observations collected by different agencies within a city. We then revisit other issues raised by the NRC and discuss how certain limitations can be easily overcome through the adoption of random coefficient models of drug prices and by paying serious attention to drug form and distribution levels. Although the sample remains a convenience sample, we demonstrate how construction of city-specific price and purity series that pay careful attention to the data and incorporate existing knowledge of drug markets (e.g. the expected purity hypothesis) are internally consistent and can be externally validated. The findings from this study have important implications regarding the utility of these data and the appropriateness of using them in econmic analyses of supply, demand and harms.Approved for public release; distribution is unlimited

Why the DEA STRIDE Data are Still Useful for Understanding Drug Markets

In 2001, use of the STRIDE data base for the purposes of analyzing drug prices and the impact of public policies on drug markets came under serious attack by the National Research Council (Manski et al., 2001; Horowitz, 2001). While some of the criticisms raised by the committee were valid, many of the concerns can be easily addressed through more careful use of the data. In this paper, we first disprove Horowitz's main argument that prices are different for observations collected by different agencies within a city. We then revisit other issues raised by the NRC and discuss how certain limitations can be easily overcome through the adoption of random coefficient models of drug prices and by paying serious attention to drug form and distribution levels. Although the sample remains a convenience sample, we demonstrate how construction of city-specific price and purity series that pay careful attention to the data and incorporate existing knowledge of drug markets (e.g. the expected purity hypothesis) are internally consistent and can be externally validated. The findings from this study have important implications regarding the utility of these data and the appropriateness of using them in economic analyses of supply, demand and harms.

An Assessment of U.S. Drug Problems and Policy

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